Reservation Request Form

Simply fill out the form below, and we will send confirmation of your reservations via E-Mail or telephone you at the number(s) provided.

Name
Address
City

 State
 Zip
Day Phone Number

Evening Phone Number
E-Mail Address

Room Reservation

Date Of Reservation (mm/dd/yy)
Number of Nights

 Total Number of Guests

In case your first choice is not available, please list an alternate date you would like to reserve.

Alternate Reservation Date (mm/dd/yy)

Room Style
(You may select more than one)

If all the information looks correct, please press the SUBMIT button below. Please note, your reservations are not made until you receive confirmation from us by E-Mail or by phone. If you have any questions, or would like to request something special for your stay, feel free to let us know!



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©2001-2003
 Edgewater Inn
1-866-783-3784
Local 738-4142
Fax: (503)738-4171